Case History 1  78 year retired Professor of History  Having lunch with friend February 06 at 13.40  Sudden onset right hemiparesis and expressive dysphasia.

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Presentation on theme: "Case History 1  78 year retired Professor of History  Having lunch with friend February 06 at 13.40  Sudden onset right hemiparesis and expressive dysphasia."— Presentation transcript:

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Currently <0.2% of patients in England, Wales and Northern Ireland receive thrombolysis

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How does thrombolysis look? 205 patients in total thrombolysed during North East 15 in Scarborough 20 in Cambridge 43 in London 12 in Oxford 16 in Dorset 17 in Devon 10 in Bristol 4 in West Midlands 7 in Stoke 17 on Merseyside 6 in Manchester 5 in Sheffield What about the other 100,000?

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Time from stroke to admission (Days)

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Time from Stroke to Admission (in hours for those admitted within 2 days)

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Brain Imaging  Only 42% of patients had brain imaging to confirm the diagnosis within 24 hours of the onset of symptoms.

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% Brain Scan Performed Within 24 hours by Region Median for all hospitals 42

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Lessons from the Audit 1.One audit is not enough. It needs to keep on coming back 2.It needs to keep evolving but with a sufficiently stable core to enable time comparisons 3.Performing badly on the audit is a very powerful tool for change. Performing well may incite complacency

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Lessons from the Audit 4.Not everything can be changed at once. Pick one or two key items to push each time data becomes available. Use the arts of spinning 5.Need a comprehensive political strategy of which audit is just one cog

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Optimism or Depression?  Best chance ever to improve stroke care  Government unchanged for next 2-3 years therefore no excuse for change in direction  NAO report due to Public Accounts Committee before the end of the parliament  Stroke seems to be near top of agenda  Likely that audit funding will be continued